ReviewJournal of medical ethics1998
Can unequal be more fair? Ethics, subject allocation, and randomised clinical trials.
Review in Journal of medical ethics, 1998. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Methodological quality and reporting of ethical requirements in clinical trials.Journal of medical ethics · 2001Pooled it
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- Effect of Pod e-Cigarettes vs Cigarettes on Carcinogen Exposure Among African American and Latinx Smokers: A Randomized Clinical Trial.JAMA network open · 2020Trial
- The adapted Zelen was a feasible design to trial exercise in myeloma survivors.Journal of clinical epidemiology · 2020Trial
- Trial
- Acute effects of an oral nitric oxide supplement on blood pressure, endothelial function, and vascular compliance in hypertensive patients.Journal of clinical hypertension (Greenwich, Conn.) · 2014Trial
- Laparoscopic versus open colectomy for TNM stage III colon cancer: results of a prospective multicenter study in Italy.Surgery today · 2012Trial
- Challenges of clinical trial design when there is lack of clinical equipoise: use of a response-conditional crossover design.Journal of neurology · 2012Trial
- An online community improves adherence in an internet-mediated walking program. Part 1: results of a randomized controlled trial.Journal of medical Internet research · 2010Trial
- Qualitative Examination of Participants' Reactions to an App-Based Military Cultural Competence Training for Helping Professionals.Journal of marital and family therapy · 2026Article
- Two-to-One Randomization: Rarely Advisable.JCO oncology practice · 2024Article
- Does nirsevimab prevent lower respiratory infections caused by respiratory syncytial virus?Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- The effectiveness of a 6-week biofeedback gait retraining programme in people with knee osteoarthritis: protocol for a randomised controlled trial.BMC musculoskeletal disorders · 2023Article
- Better late than never? Impact of delayed elective interventional pain procedures due to the COVID-19 pandemic.Interventional pain medicine · 2023Article
- Unequal allotment of patients in phase III oncology clinical trials.American journal of cancer research · 2021Article
- Evaluating the effect on asthma quality of life of added reflexology or homeopathy to conventional asthma management - an investigator-blinded, randomised, controlled parallel group study.European clinical respiratory journal · 2020Article
- The impact of reflexology and homeopathy added to conventional asthma treatment on markers of airway inflammation - a randomised study.European clinical respiratory journal · 2020Article
- The Role of Clinical Examination in Midface Volume Correction Using Hyaluronic Acid Fillers: Should Patients Be Stratified by Skin Thickness?Aesthetic surgery journal. Open forum · 2020Article
- A pragmatic, adaptive clinical trial design for a rare disease: The FOcal Cerebral Arteriopathy Steroid (FOCAS) trial.Contemporary clinical trials · 2019Article
Corrections and comments
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Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Randomised clinical trials provide the most valid means of establishing the efficacy of clinical therapeutics. Ethical standards dictate that patients and clinicians should not consent to randomisation unless there is uncertainty about whether any of the treatment options is superior to the others ("equipoise"). However, true equipoise is rarely present; most randomised trials, therefore, present challenging ethical dilemmas. Minimising the tension between science and ethics is an obligation of investigators and clinicians. This article briefly reviews several techniques for addressing this issue and suggests that unbalanced randomisation, a technique rarely employed in current clinical trial practice, may be useful for enhancing the ethical design of human experimentation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.